Permit r ,
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CITY TIGARD MECHANICAL PERMIT
��,, DEVELOPMENT SERVICES PERMIT #: MEC2005 -00381
{III 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/23/2005
PARCEL: 2S1 12 B D -0 5200
SITE ADDRESS: 07916 SW LEISER LN ZONING: R -4.5
SUBDIVISION: LEISER PARK LOT: 016 JURISDICTION: TIG
Project Description: AC install.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PATRICK HAYES Description Date Amount
7916 SE LEISER LN. [MECH] Permit Fee 6/23/200t $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 6/23/200: $5.80
Phone: 503 684 - 8946 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 - 557 - 2220
Reg #: LIC 72623
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -800- 332 -2344.
Issued By: ' f Permittee Signature: l ' i
Call 503 - 639 -4175 by 7 :00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Mechanical Permit Application ' • . FOR ^OFFIC .°USE ONLY
City of Tigard NolSlAla ONla7111e Received Permit No,
17125 SW Hall Blvd -, Tigard,014954 -- v 7,„,..--c,._3/ S c_c oo; °o3g
d 0 �lll9 ?Ian 1t.eVie
Phones: 503.639,4171 Fax: 503.598.1960 44 11 +\ UateB y Other Permit.
Inspection Line; 503.639.417.5 ' 1 I /I
t C ? RIni /° T ! y i�- 91 Date Notified/Method: �u , ls r, See Pup Z for
Internet: www.ci.tigard.or,us1U V NatifiedRvteth /`� Supple :WentµlInformation
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u v „ ---v /i 1 Mechanical ermit foes" are based on the value of the work
0 New construction dih eration/replacement P
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Qet olition ❑ Other: , mechanical materials, equipment, labor, overhead, and profit.
: , ju :.;�• , .q' , i .m,y ..aa, as „U�. .jilt' .a:.. r w g tr. 77 ::1
l: . t l i{.° �L,n,” 0.. l $tJ t • " . ' t .F. pN '; : . :. .: .. `
..;,�a;; x•i:.: k�5lll,iirr J' X'.f -^ �:,�,.. , ,,,,,.,Q,.. i,�,ir ! ' ;�r- 'II:'. Value:
0 1 - and 2- family dwelling El Commercial /industrial ❑ Accessory budding F3g �' - � t 4lS YSi EES°
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❑ Master builder ❑ Other: For.rpeclal lnfOYmnl( ors use checklist.
)'T Description Qty, Ea, Total
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ng/C0011ng
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.., .,.i. T .._.�. , .,.. , -G lr.•.' ., .. '... .. .:. I,., li .t•�..I�ii'�ftrlF:d. �, I: Fen
Job site address: ' / I �j� - C `j Air conditioning in heat pump /(l i,
( �1 4i! $ / -/ .e /� . 1 / _ f re tires site p lan sl tuwin _ pi u«ement � 1 I a.ao ! 7
City /State/ZIP: _ -� �q ;3 Furnace 100,000 BTU (dims/vents) 14,00
Furnace 100 000± BTU {ducts /vents) 17,90
Suite/bldg./apt. no.: J Project name: Gas heat .urn 14.00
Cross 3h to job site: Duct work 14.00 _
Hydronic hot water system 14.0
-__�- Residential boiler (radiator or
12ydronic) 14.00
- • -.,-•- Unit heaters (tLel -type, not electric),
_____ in -wall, in -duct, suspended, etc. 10,00
Subdivision: Lot no,: ` Flue/vent for any of above 10.00
Tax map/parcel no.: — °° Other: 10,00,
Other foal appliances
:Pi , :.g$1`, lgy ,,,., A.- y �;;+ a
e: yy „ .: „ y`y i t^ , el p7 : ;: ,, , I1,, :, :n1I. I i•.I I". Water heater
..:4::�. r1: hbq i :.4[ ., )f.# '4 0 50,,' , r r� w,;t:-� ,:.yy,����u td, : : . 4 'rf, ;`,: :: u�:i "'7 } l "'!;: r .,
�:;:G. � ,. .�I p,, .1,. •a:ir:'^ , t:.. . .�. `,l�``.....,.._,.�...i..`•':!r, OE�;�'�'�. .. ,.+,...r � \'!.7n... �':, „•l:,p', "l�r ai�'i -��. 10,00
y y g •, + -- 10,00
Gas fireplace _
/ " .. /. if 1 - Flue vent for water heater or 353
fireplace. - 10.00
- - - -- -- Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /inaert 10,00
1'� ? rt ,li 1 C`hilj' ";yce;' '.);i ?' , 3 �l; �a., F' 1,l CChimney/liner/flue/vent 10.00 ___ ,1.3 ' tsrro I � �� u � y �: :.[.; . ,, t. � � �<R:�' t: �.: � %�''�',iY: i
: ;
r� l, n.. : .':'i�.. lliW! ,...�. .a.... la'1�A� = R,,r,��thGi!; Other: 10,00
Nai i '
Environmental exhaust and ventilation
Address: ,...-
.- Range hood /other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Phone: -” —' Single-duct exhaust (bathrooms,
(b ) 1 1 ✓ Fax: ( ) toilet compartments, uti1ilZ rooms 6,80
` T. TI'I Y I ', l .:ry..,. ..t.:' .Ji „r ,. •+ - ,� -
z7, '; s" ;,l )FiA ilA ' r t! ',,.z,, -,� I ,... ,� P , ' .At tic /craw
; : •.' u " ' ", : • : 0:. .fi l 4- P',. h'I!I F ^ 1: ,1, • ;1: i , . :....- f 1 , :4 i. .li::,,; [space fans IO.0
.�....�1,:- 1,;41. � SL. .. ,��' u;,Nlt:':�(L ;��,: itlr,. I t 'ID6 1 �v � ., �' " °t. � +.� . t�tl?�ki;�'' ,
I'�� _. .....,., U
i au T mp CO�t � �...._ Other: _ 10,00
Puel Business name: Other;
piping_ RRg_
Contact name: r �/� �j� $5.40 for tirst four; $1.00 for each additio
Address: �' I ,t'4' O • ` • 0 a '� (1 Ri / Z Furnace, eft, - , __�..
City /State /'LIP: IM.()) } C C Gas heat pump
7 _ Wall/suspended/unit heater
Phone: (fa"Va .. Z22.0 ) x,5'7', Fax: : (' �: 3) - 5' 1 1 - 1 i q — Water heater
. E-mail: - Fire -� _
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. ` a l r 15 k; iy! ., �...� I�, .�T•' 7 •; t_ "1
N7] s 71 i l � '
114 "a ;U'tfi i l'P: es.' 7 ,41 . A .PLO I � t .
'i . ° ..11 i I ,1ti; 4'�i , �f }, 'f�:`��l'>illR iii I , Ir ,,, • Qatbecue ...,.. - ,. •
' Business name: Trl cc -Fe Ci��� -f'}-r J Y Clothes dryer (gas)
1: 0 n ° I �',/ t i t �� Other: _
Address: ti , �. r,r ;' Nli �- ,� 14,1 .,: --
1 ,`� rr t y - n:a;.
City/State/ZIP: or T. 0 ! . L I O -. cl 04) subtotal _..,, _
Ph ( 5_,-5 ) G - I Fax hv^� Minimum permit fee (572,50) t_'
`) 4 - - 0 S.57 M Plan review (25 % of permit fee) •
CC'B tic.:
r�,�,! State surcharge (8% of permit fee)
- - _ _ TOTAL PERMIT FEE % ,�
Authorized signature: / i _ ; 'rllie Ntltmit upplicntion expires if 1- permit is not obtulned Iv1Clfln f80
days after it hat been accepted ae completes.
Print name: . � -7 Ki � 1 r 4±4e it / Date: P ' / • Foe metliuduli,gy set by Tn't= +aun)Y Building tnduatry Service Board
i:0iuilding \Per nits \MIiC- Permitgoo.4oc 12/03 440 -4617T (I I /OLCOM/WBB)
Ed WUES:60 SOOZ 2E 'unf 6160LSSOES: '0N Xdd I0.4.uo0 dwal Fq.uno0 ?al: WOdd
1 .. 74 STA/..1-+.1'10 t'i ALDR.E:r..7::
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00381
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005
Phone: (503) 639 -4171 am l'
Inspection Requests (24 Hrs.): (503) 639 -4175 `__ 49c,_-.3
INSPECTION WORKSHEET FOR ' DATE: 6/27/2006 TIME: 7:09AM PAGE: 47
SITE ADDRESS: 07916 SW LOSER LW CLASS OF WORK:
SUBDIVISION: LEI SER. PARK LOT #: 016 TYPE OF USE:
PROJECT NAME: HAYES
DESCRIPTION: AC install.
OWNER: HAYES, PATRICK PHONE #: 503-6848946
CONTRACTOR: TRI COUNTY TEMP CONTROL PHONE #: 503- 557 -2220
Inspection Request Scheduled For: Date: 6/27/2006 Pour Time: • .
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010205 -01 503 - 557 -2220 N
Corrections /Comments /Instructions:
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- P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /t (� Dat W7-7/0 Phone #: 503 718 -
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